Abstract Perspective: Integration of risk survival measures estimated from pre- and post-treatment CT scans improves stratification of early stage non-small cell lung cancer patients treated with stereotactic body radiation therapy

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Non-small cell lung cancer (NSCLC) has poor treatment outcomes. Patients diagnosed with early stage NSCLC are now more likely to receive definitive treatment with the increased utilization of convenient and effective hypofractionated radiotherapy such as stereotactic body radiation therapy (SBRT). However, despite excellent initial local control, up to half of patients with early stage NSCLC will fail regionally and/or distantly within five years after SBRT. Early prediction of clinical outcomes of these patients will inform decisions to add treatment after SBRT. Radiomics provides promising novel biomarkers towards predicting clinical outcomes. Particularly, radiomic features extracted from CT images have demonstrated promising performance for the prediction of overall survival and disease-free survival in patients with NSCLC. Moreover, changes in radiomic features, often referred to as delta-radiomics features, have also demonstrated prognostic potential in lung cancer. Aiming to improve prediction of overall survival of ES-NSCLC patients treated with SBRT, a radiomic model was developed to integrate risk of death estimates based on pre- and post-treatment CT scans in patients receiving SBRT. Evaluation results have demonstrated that this radiomic-based longitudinal risk analysis allowed us to stratify patients with various overall survival outcomes with greater accuracy.

– Study author Fan Young, MD